Expanding the role of photoselective vaporization of the prostate.

The use of the potassium-titanyl-phosphate (KTP) laser for the ablative treatment of lower urinary tract symptoms secondary to benign prostatic hyperplasia (BPH) has gained wide acceptance in the urologic community. The efficacy and safety of photoselective vaporization of the prostate using 60-W or 80-W KTP have been demonstrated in multiple trials, with significant impact on special high-risk surgical populations (ie, patients with large prostates and anticoagulated patients with multiple comorbidities) with symptomatic BPH. The high-power KTP laser technique has also shown encouraging results in the management of urethral strictures. With catheter removal, improvement in voiding may not immediately occur; however, with the efficient vaporization and limited coagulation necrosis that are routinely noted with high-power KTP applications, improvement may occur in as early as a few days to 1 week. Because of the superior surgical hemostasis associated with laser prostatectomy, no restrictions on physical activity are required after the procedure, even in the immediate postoperative period.